Elsevier established a free COVID-19 resource center in January 2020, offering information in English and Mandarin. The center grants free access to its research in PubMed Central and other repositories for unrestricted reuse. The article discusses gastrointestinal manifestations and potential fecal-oral transmission of COVID-19. The virus initially emerged in Wuhan, China, and has caused global outbreaks. Common symptoms include fever, dry cough, and dyspnea, similar to SARS and MERS. However, gastrointestinal symptoms like diarrhea, nausea, and vomiting are also reported, with some cases showing viral presence in stool. Evidence suggests that SARS-CoV may have infected the gastrointestinal tract, possibly explaining these symptoms. A U.S. case showed viral detection in stool and respiratory specimens. Saliva testing also revealed viral presence, indicating possible transmission via saliva. Recent studies isolated live virus from stool samples, suggesting fecal-oral transmission. The virus shares 79% sequence identity with SARS-CoV, and both use ACE2 as a receptor. ACE2 is expressed in the gastrointestinal tract, raising concerns about infection via this route. Liver injury is also reported in some patients, with ACE2 expression in bile duct cells suggesting possible liver damage. The article emphasizes the need for vigilance in gastrointestinal symptoms for early detection and intervention. It calls for accelerated research on ACE2-based strategies for diagnosis and treatment. The study highlights the importance of understanding alternative transmission routes and the potential for asymptomatic or mild cases to be overlooked.Elsevier established a free COVID-19 resource center in January 2020, offering information in English and Mandarin. The center grants free access to its research in PubMed Central and other repositories for unrestricted reuse. The article discusses gastrointestinal manifestations and potential fecal-oral transmission of COVID-19. The virus initially emerged in Wuhan, China, and has caused global outbreaks. Common symptoms include fever, dry cough, and dyspnea, similar to SARS and MERS. However, gastrointestinal symptoms like diarrhea, nausea, and vomiting are also reported, with some cases showing viral presence in stool. Evidence suggests that SARS-CoV may have infected the gastrointestinal tract, possibly explaining these symptoms. A U.S. case showed viral detection in stool and respiratory specimens. Saliva testing also revealed viral presence, indicating possible transmission via saliva. Recent studies isolated live virus from stool samples, suggesting fecal-oral transmission. The virus shares 79% sequence identity with SARS-CoV, and both use ACE2 as a receptor. ACE2 is expressed in the gastrointestinal tract, raising concerns about infection via this route. Liver injury is also reported in some patients, with ACE2 expression in bile duct cells suggesting possible liver damage. The article emphasizes the need for vigilance in gastrointestinal symptoms for early detection and intervention. It calls for accelerated research on ACE2-based strategies for diagnosis and treatment. The study highlights the importance of understanding alternative transmission routes and the potential for asymptomatic or mild cases to be overlooked.